Preoperative assessment and postoperative outcome of total hip replacement in adults with AVN

Author(s): Nadir Shah, Ayush Kumar Singh, Arohi Sharma, Eknath Pawar, Safiuddin T Nadwi and Vipul Shet

Abstract: Introduction: Total hip replacement has been proven to be the treatment of choice for patients with intolerable pain and limitation of movement due to avascular necrosis since many years. The success of total hip replacement is the outcome of the surgery that enables to relieve the pain associated with the hip point pathology while maintaining the mobility and stability of the hip joint for many years. Non cemented hip arthroplasty has taken over in the recent times and replaced conventional cemented total hip arthroplasty in young adults, it has developed in response to evidence that cement debris play an important role in promoting bone lysis and loosening. Aim: At our institution, a study is undertaken to assess the clinical and functional outcomes of uncemented total hip replacement in patients with osteonecrosis of femoral head. Methods: This prospective study was conducted at Grant Medical College & JJ Hospital. 25 patients with 25 diseased hip between the ages of 40 to 85 years operated for uncemented total hip arthroplasty by posterior approach between July 2014 to August 2015 were included in the study. Clinical scoring was done using Modified Harris Hip Score along with radiological analysis on follow up. 6 weeks, 3, 6, 12 and 24 months and at latest follow up. Result: In our study the mean preoperative modified Harris hip score (Table 3) was 45.04 with minimum of 21 and maximum of 62.The immediate mean postoperative modified Harris hip score was 88.44 with a minimum of 74 and maximum of 95. The mean follow-up Harris hip score increased to 91.28 with a minimum of 77 and maximum of 97.There was a significant improvement in the follow up Harris hip score(modified) with a p value of 0.044(<0.05). All patients who were included in our study had poor score preoperatively. In the follow up 21(84%) had excellent results, 2(8%) had good result and 2(8%) had fair results in the follow-up which is a significant improvement in the modified Harris hip score. Conclusion: This study has shown that the outcome of the total hip arthroplasty has shown excellent results in terms of pain relief, increased walking distance, and functional capabilities in patients.

DOI: https://doi.org/10.22271/ortho.2017.v3.i3n.144